Ontario’s long-revered health-care system is a mess, with huge executive pay raises, growing use of lobbying firms paid with tax dollars and a mounting culture of fear that pervades all parts of the system.

But despite a volatile cocktail of bureaucratic waste and questionable use of tax dollars, Health Minister Deb Matthews has failed to address these issues that threaten the integrity and effectiveness of the health-care system.

Importantly, since Matthews was named health minister in 2009, Ontario’s health-care system has displayed disturbing signs of decay, particularly in community care which Matthews boasts as one of her big successes.

Evidence of trouble is rampant.

First, executive salaries at Community Care Access Centres, which govern home care in Ontario, have skyrocketed while low-paid workers who actually deliver services to patients haven’t seen their incomes rise in a decade — and in many cases have actually suffered significant drops.

Second, the 14 CCACs are now using tax dollars meant for patient care to pay for lobbying firms that advise the CCACs on how to “sell” their message to politicians at Queen’s Park.

Fourth, a reign of fear and intimidation imposed by CCAC bureaucrats has effectively shut up critics of the system, especially those employed by private companies that have contracts with CCACs to provide the workers who actually deliver services to patients.

“Many of us in the community have been very frustrated for some time,” the president of a private service provider wrote this week in an email. “We are not able to speak out on any of these issues in fear of jeopardizing our contracts.”

How, indeed, does Matthews justify huge CEO wage increases and wage inequalities? Why does she overlook a culture of fear that’s so pervasive among those under her portfolio?

Here are the salaries for the chief executive officers at the 14 CCACs in Ontario. The figures were obtained under the Ontario Public Sector Salary Disclosure Act, which requires the listing of all salaries of $100,000 or more in a calendar year.

The list includes salaries for 2012, the latest year available, and for 2009, the year Matthews became minister.

1. Toronto Central: This CCAC serves the central part of Toronto; CEO Stacey Daub $233,380; predecessor in 2009 earned $180,001, a 30-per-cent increase over three years.

2. Central: Serving north Toronto and most of York Region; CEO Cathy Szabo $271,734 ($180,001 in 2009), a 50-per-cent jump in three years.

3. Central East: Based in Ajax and serving much of Durham Region; Donald Ford $182,160 ($180,001 in 2009), just a 1-per-cent-jump.

12, South West: Based in London; Sandra Coleman $267,500 ($180,046 in 2009), a 48-per-cent hike.

14. Waterloo Wellington: Based in Kitchener; Kevin Mercer, $227,995 in 2011, his last full year (predecessor paid $159,996 in 2009), a 42-per-cent increase.

That’s an average salary of $234,000 a year, with an average raise of 12 per cent annually over the three-year period.

By contrast, many personal support workers and other health-care workers earned less than $20,000 a year, with no raise at all in the same period.

At the same time, the Ontario Association of CCACs has hired Strategy Corp., a high-powered consulting and lobbying firm, to work on their behalf. Strategy Corp. was first contracted in 2012 to help OACCAC officials strengthen their media relations and MPP outreach programs. Strategy does not directly lobby MPPs; that is left to CCAC officials.

Still, how does Matthews justify allowing the OACCAC, which gets its $30-million annual budget both from the 14 CCACs and Queen’s Park, to spend tax dollars on consultants when the former health ministry executives who have led the OACCAC can pick up the phone any day of the week and get the minister on the line?

Matthews insists she’s “open to new ways of doing things.” By her inactions, though, it is clear she isn’t.

To correct this, Premier Kathleen Wynne should step in and order a full audit of all the CCACs’ books and a full review of their role in the health-care network.

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